Examining the Mechanisms and Consequences of Poor Sleep Health Among Black Gay Men - Black gay men experience notably higher rates of HIV, mental health, and physical health problems. Stressors at individual and contextual levels such as perceived negative interpersonal experiences and low socioeconomic status contribute significantly to these poor health outcomes. Sleep health, an understudied factor, may play a crucial role in mediating these suboptimal health outcomes. Based on emerging evidence from cross-sectional data indicating that self-reported sleep may be compromised in Black gay men, we propose to conduct a community-based study using a longitudinal mixed-methods design to investigate sleep health as a pathway linking individual- and contextual- level stressors and health consequences in Black gay men. We will collect three waves (baseline, 6-month, and 12-month follow-ups) of quantitative data using questionnaires/surveys, daily diary, and actigraphy (objective sleep monitoring) from 300 Black gay men. In a subsample of 60 participants, we will conduct in-depth qualitative interviews at baseline and 12-month follow-up. The proposed longitudinal mixed-methods study will: 1) examine quantitatively the proximal (daily) and longitudinal associations between individual and contextual stressors and suboptimal sleep health among Black gay men and the extent to which coping with the stressors mediates the longitudinal effect; 2) examine quantitatively the role of sleep health as a mediating pathway between risk factors and health consequences longitudinally, and the proximal associations of poor sleep on next day’s mood and substance use; and 3) to explore qualitatively how individual/interpersonal-level (e.g., sleep behaviors, negative interpersonal experiences, coping strategies) and contextual-level (e.g., housing conditions, neighborhood safety and crime) factors influence sleep health and how sleep is related to other health outcomes (e.g., mental and physical health) over time. Qualitative interviews will also explore possible solutions to address the barriers identified. Input from community members and stakeholders will be sought and incorporated throughout the study. The mixed-methods results and community input will serve as a basis to inform sleep health promoting policies and approaches to support health for this group. Drawing upon an established community-academic partnership, this study will be the first longitudinal mixed-methods community-engaged research to illuminate how compromised sleep health contributes to adverse health outcomes affecting Black gay men. The proposed study aligns with the goals of Healthy People 2030 and the NIH Sleep Research Plan. It also aligns with MAHA’s priority of addressing sleep as a root cause of chronic health conditions. Findings from this comprehensive investigation will pave the way for tailored intervention efforts and help promote health through enhancing sleep health.
